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Individuals With Weaker Antibody Responses After Booster Immunization Are Prone to Omicron Breakthrough Infections

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FRONTIERS IN IMMUNOLOGY
卷 13, 期 -, 页码 -

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FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2022.907343

关键词

SARS-CoV-2; booster vaccination; breakthrough infection; COVID-19; humoral immune response; neutralization; anti-spike antibodies

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The risk of developing an Omicron breakthrough infection was found to be 10 times higher in individuals with low pre-infection anti-spike antibodies and weaker neutralization capacity against Omicron one month after the booster vaccination. Routine testing of anti-SARS-CoV-2 IgG antibodies and surrogate virus neutralization can help identify individuals at risk for breakthrough infections.
BackgroundDespite the high level of protection against severe COVID-19 provided by the currently available vaccines some breakthrough infections occur. Until now, there is no information whether a potential risk of a breakthrough infection can be inferred from the level of antibodies after booster vaccination. MethodsLevels of binding antibodies and neutralization capacity after the first, one and six month after the second, and one month after the third (booster) vaccination against COVID-19 were measured in serum samples from 1391 healthcare workers at the University Hospital Essen. Demographics, vaccination scheme, pre-infection antibody titers and neutralization capacity were compared between individuals with and without breakthrough infections. ResultsThe risk of developing an Omicron breakthrough infection was independent of vaccination scheme, sex, body mass index, smoking status or pre-existing conditions. In participants with low pre-infection anti-spike antibodies (<= 2641.0 BAU/ml) and weaker neutralization capacity (<= 65.9%) against Omicron one month after the booster vaccination the risk for developing an Omicron infection was 10-fold increased (P = 0.001; 95% confidence interval, 2.36 - 47.55). ConclusionRoutine testing of anti-SARS-CoV-2 IgG antibodies and surrogate virus neutralization can quantify vaccine-induced humoral immune response and may help to identify subjects who are at risk for a breakthrough infection. The establishment of thresholds for SARS-CoV-2 IgG antibody levels identifying non-, low and high-responders may be used as an indication for re-vaccination.

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